Journal of anesthesia
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Journal of anesthesia · Jan 2006
Effect of clonidine premedication on postoperative sore throat and hoarseness after total intravenous anesthesia.
To determine the effect of oral clonidine premedication on postoperative sore throat and hoarseness, we evaluated the incidence and severity of each of these complications in patients who underwent elective surgery in the supine position. The subjects were 82 patients, American Society of Anesthiologists (ASA) status I-III, aged 15-82 years. They were premedicated with either 150 microg oral clonidine and 20 mg raftidine (clonidine group; n = 41) or with 20 mg raftidine only (control group; n = 41) 2 h before anesthesia induction. ⋯ The incidences of sore throat and hoarseness tended to be higher in the clonidine group than in the control group; however, the difference did not reach statistical significance. There were no significant differences in the severity of these symptoms between the two groups. In conclusion, oral premedication with 150 microg clonidine did not prevent postoperative sore throat or hoarseness, and may have exacerbated these symptoms.
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Journal of anesthesia · Jan 2006
Case ReportsIdentification of the lumbar intervertebral level using ultrasound imaging in a post-laminectomy patient.
A spinal block was performed in a post-laminectomy patient, using both ultrasound imaging and X-ray imaging. Ultrasound imaging clearly identified the L3/4 intervertebral level, the spinal canal, the corpus vertebrae, and the dura mater. ⋯ A 25-G needle for the spinal block was accurately advanced into the spinal canal with the use of X-ray imaging (43 mm from the skin to the subarachnoid space). We report here that ultrasound imaging was useful for performing a spinal block in a post-laminectomy patient in whom there was anatomical change around the spine.
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Journal of anesthesia · Jan 2006
Effect of high-frequency jet ventilation on oxygenation during one-lung ventilation in patients undergoing thoracic aneurysm surgery.
To evaluate the effect of high-frequency jet ventilation (HFJV) and continuous positive airway pressure (CPAP) on oxygenation and the shunt fraction (Qs/Qt) during one-lung ventilation (OLV). ⋯ Both HFJV and CPAP can improve oxygenation during OLV.
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Journal of anesthesia · Jan 2006
The effects of ropivacaine at clinically relevant doses on myocardial ischemia in pigs.
A major risk associated with bupivacaine during myocardial ischemia is ventricular fibrillation. We investigated the influence of ropivacaine on cardiac contractility and the propensity to ventricular fibrillation before and after myocardial ischemia in a placebo-controlled pig study. Anesthetized domestic pigs were administered 1 mg.kg(-1) of ropivacaine intravenously over 1 min and then 0.03 mg.kg(-1).min(-1) as a 30-min infusion, or saline. ⋯ We also found that the effect of ropivacaine on the VFT was coronary blood flow-dependent, with a markedly decreased threshold in the presence of ischemia. Similar effects have been observed in humans with several other local anesthetics, as well as with class I antiarrhythmic drugs. The results of this study should be taken into account by anesthesiologists when administering ropivacaine to coronary patients.
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Journal of anesthesia · Jan 2006
Case ReportsPostoperative airway obstruction after airway tumor debulking.
Postoperative airway obstruction is a relatively common complication after anesthesia, occurring most often after head and neck surgery. We present a case of postoperative airway obstruction in a patient who underwent airway tumor debulking. This case demonstrates that, in high-risk patients, despite the traditional methods of determining eligibility for extubation, postoperative airway obstruction can still occur, and alternative means of extubation should be considered.